ABSTRACT
Background: End stage renal disease (ESRD) shows higher prevalence in poor urban communities, areas with high SARS-CoV-2 exposure risk. This ecological analysis examined the correlation of SARS-CoV-2 positive tests per capita with number of dialysis stations, demographics and income data of the residents within ZIP codes (n=163) in Cook County, Illinois. Methods: Data on SARS-CoV-2 positive tests per capita within a ZIP code were merged with ZIP code data on number of dialysis stations (sum of dialysis stations per dialysis center), demographics and household income, during a period from January 21-May 16, 2020 in Cook County (5,231,852 residents). Spearman's rank correlation coefficients were calculated to examine the linear correlation of SARS-CoV-2 positive tests per capita with dialysis stations, demographics and household poverty. We mapped SARS-CoV-2 positive tests per capita and total dialysis stations by ZIP code in Cook County. Results: Positive tests per capita correlated significantly with number of dialysis stations (r = 0.23;95% CI 0.18, 0.28;P < 0.005), number of households living in poverty (r= 0.58;95% CI 0.54, 0.61;P < 0.005) and percentage of residents reporting Black race (r = 0.34 p < 0.005, CI = 0.30, 0.39) or Hispanic ethnicity (r = 0.60 p < 0.001, CI: 0.57- 0.63). Figure 1 show several areas within Cook County with both high number of SARSCoV- 2 tests per capita and number of dialysis stations. Conclusions: SARS-CoV-2 tests per capita correlates positively with number of dialysis stations, and poverty status of that ZIP code. These findings highlight the high risk of SARS-CoV-2 exposure for patients with ESRD living in poor urban areas.